VICKI SUE REVAK (NPI# 1972075356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972075356 |
| Entity Type | Individual |
| Full Name | VICKI SUE REVAK |
| Other Name | VICKI SUE KAISER |
| Credential | MSN, AGAC-BC |
| Practice Address |
680 Blair Mill Rd Horsham PA 19044-2223 |
| Mailing Address |
10757 Pont Rd Albion PA 16401-8605 |
| Practice Telephone | 2672614413 |
| Mailing Telephone | 8143364865 |
| Enumeration Date | 2018-12-22 |
| Last Update Date | 2019-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
SP019667 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
680 BLAIR MILL RD |
| City | HORSHAM |
| State | PA |
| Zip Code | 19044-2223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458646 | Genevieve Katherine Burns | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2005-06-22 |
| 1619575768 | Kara Elyse Cunningham | Registered Nurse | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-10-12 |
| 1609473222 | Joshua Paul Bickford | Registered Nurse | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-10-06 |
| 1922619378 | Erica Detweiler | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-08-10 |
| 1023628013 | Vanessa Rae Fischer | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-08-04 |
| 1750909255 | Patricia Fitzgerald | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-07-10 |
| 1750908281 | Johanne Kamleu | Registered Nurse | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-06-30 |
| 1760008973 | Jesse Greiner | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-06-23 |
| 1588299820 | Stefanie Phillips | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-03-06 |
| 1578196457 | Danielle Kent Romano | Registered Nurse | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2020-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326687724 | Nan Nursing Services LLC | Home Health | 300 Welsh Road, Bldg One Ste 100, Horsham, PA 19044 | 2020-01-02 |
| 1922645217 | Nutritional Living, LLC | Dietitian, Registered | Horsham Athletic Club, 400 Horsham Road, Horsham, PA 19044 | 2019-12-05 |
| 1669941027 | Walettra Charmese Enoch | Nurse Practitioner | Inspiris Services Company- Pa, 680 Blair Mill Road, Horsham, PA 19044 | 2018-11-15 |
| 1437624244 | Highpoint Pain & Rehabilitation Physicians | Non-Pharmacy Dispensing Site | 2 Village Road, Horsham, PA 19044 | 2018-10-08 |
| 1487177366 | John Devine | Nurse Practitioner | 680 Blairmill Road, Horsham, PA 19044 | 2017-07-21 |
| 1396063533 | Joanna M Ronkowski-ziegast | Chiropractor | 237 W. Moreland Ave, Horsham, PA 19044 | 2010-05-12 |
| 1538499488 | Elizabeth Alison Lillo | Nurse Practitioner | 680 Blair Mill Road, Horsham, PA 19044 | 2009-12-28 |
| 1730390360 | Chitra Lekha Gupta | Pathology | 900 Business Center Drive, Quest Diagnostics Incorporated, Horsham, PA 19044 | 2007-05-25 |
| 1306056122 | Frances T Levin | Social Worker | 110 Gibraltar Rd, Suite 103, Horsham, PA 19044 | 2007-05-23 |
| 1407078439 | Judith M Olimpo | Pharmacist | 56 Woodbine Court, Horsham, PA 19044 | 2007-05-02 |
| Find all providers in zip 19044 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871149815 | Anu Antony Kunjukutty | Nurse Practitioner | 611 Tall Pines Ln, Horsham, PA 19044-1802 | 2019-08-15 |
| 1467503250 | Schyuler Barbour | Nurse Practitioner | 650 Blair Mill Road, Horsham, PA 19044 | 2007-01-16 |
| 1194389692 | Sotheara Keat | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2019-04-30 |
| 1588129126 | Alyxandra Howard | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2019-02-07 |
| 1932618683 | Teresa Gieron | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2017-09-26 |
| 1922540871 | Amy Beth Woodruff | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2016-11-09 |
| 1346609823 | April Firchow | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2016-02-12 |
| 1528436748 | Kelly Kronemeyer | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2015-09-03 |
| 1184020943 | Sharon Adele Treusdell | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2014-11-06 |
| 1679998637 | Laura A Binkley | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2014-02-28 |
| Find all providers in HORSHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.